天津市河北区HIV抗体初筛阳性样本的复检及免疫印迹试验结果分析

Analysis on results of re-examination and immunoblotting of HIV antibody positive samples in screening,Hebei district,Tianjin city

目的通过分析天津市河北区HIV初筛阳性样本的检测数据及免疫印迹试验(WB)带型分布特点,为辖区艾滋病防治工作及确证实验室提高检测能力提供科学依据。方法收集2016~2018年7月底河北区疾病预防控制中心HIV确证实验室所辖全区各筛查实验室送检的HIV抗体初筛阳性样品共计189份,依照《全国艾滋病检测技术规范》采用原有试剂双份或双孔或者2种试剂检测,结果均为阳性或1阴1阳的样本用蛋白印迹法(WB)进行确证检测,并对阳性结果的带型进行分析。结果 189份初筛阳性样本经复检阳性180份,阳性率为95.24%。不同人群确证阳性率差异有统计学意义(P<0.05)。180份复检阳性样本进行确证试验,阳性率为92.78%(167份);不确定7份,占复检阳性的3.89%。带型分布出现全条带者58份。结论 ELISA试剂存在不可避免的假阳性,慎重对待HIV确证试验的不确定结果,提高WB条带判读能力,减少不必要的误读。

Objective To analyze the detection data of HIV positive screening samples and the distribution characteristics of immunoblotting test(WB) in Hebei district,Tianjin city,so as to provide scientific evidence to further prevent and control AIDS and improve the detection ability of confirmation laboratory. Methods A total of 189 positive samples of HIV antibody were collected from various screening laboratories under the jurisdiction of the HIV Confirmation Laboratory of Hebei Center for Disease Control and Prevention at the end of July 2016-2018.Samples with test results of positive or of 1-positive 1-negative by double-dose original reagent,double-pore or 2 reagents test according to the National AIDS Testing Technical Specification were detected by Western blotting(WB) and the bands of positive results were analyzed. Results A total of 189 positive screening samples were retested,with 180 retest-positive samples,and the positive rate was 95.24%.There was statistically significant difference in the confirmation positive rate among different populations(P<0.05).The confirmatory test was conducted to the 180 retest-positive samples,and the positive rate was 92.78%(167 samples);there were 7 uncertain samples,accounting for 3.89% of the retest-positive samples.There were 58 full-band bands in the band pattern distribution. Conclusion There are inevitable false positives related with ELISA reagents.The uncertain results of HIV confirmation tests should be taken with due caution.The ability of WB strip interpretation should be improved to reduce unnecessary misreading.